VBAC vs planned c-section?

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VBAC vs planned c-section?

January 13, 2011 09:19 PM

Your book
was recommended to me through a friend of a friend. I
haven’t had a chance to read it but I looked at the chapter
contents and I still have a rather big question/dilemma. My first
pregnancy was awesome. I loved every minute of it and I cannot
remember any sort of complications… that is until I was
about 38 weeks. I woke up in the middle of the night to go to
the bathroom and as I got up, I felt fluid b/w my legs. I
thought my water had broke but when I got to the bathroom I was
bleeding profusely. We called the ambulance and I was taken
to our nearby hospital (but not the hospital I wanted to give birth
in) I had partially abrupted, the bleeding had
stopped on its own but I was admitted to the delivery
floor. I was induced first with Cervadil (? Spelling) which
did not work. Then it was encouraged to me that I induce labor. I
was induced with Pitocin, my water was broken and labor came fast
and furious so I received an Epidural. When I was ready to
push we pushed for about 2 hrs… my dtr would not come
… forceps were used multiple times and the vacuum was used
even more. The pain was unbearable. I also
received an episiotomy. My dtr’s heart rate dropped
dangerously low and all of sudden we were going for an
emergency c-section. I passed out b/w the DR and the OR, I
was tubed for the section and my dtr was born. Her apgar was
3-4, she had swallowed meconium and an ultrasound of her head
showed a small bld in her head as a result of the
vacuum.

My dtr
was in hospital for just over a week and was released home with no
ill effects and is now thriving normally at the age of two
(thank god!!) I required 2 units of bld and a week in
hospital.

I am now
pregnant again and terrified of a repeat performance.

What are
the chances of another abruption (partial or complete)? Am I
at higher risk?

My mother
was unable to delivery her babies vaginally… is there a
correlation?

Is a VBAC
possible? I almost don’t even want to try and my husband is
understandably very afraid for us.

I am
hoping for any and all information I can get!

Thank you
for reading this and any reply.

We
appreciate it!

Henci Goer

I am happy that you and your daughter are OK but so sorry
that you have been through this terrifying experience. I
want to start by recommending Solace for Mothers, a website
with information and a peer support community for women who have
had traumatic birth experiences.

As for the likelihood of a repeat placental abruption (the
placenta detaches partially or completely before the birth), I do
not know the statistics on how likely it is likely to repeat,
especially in a healthy woman with no predisposing factors such as
extremely high blood pressure. That would be a good question
for your care provider.

As for VBAC, let me start by saying that the fact that your
mother had her babies by cesarean means nothing. The cesarean rate
in this country and most others has been so high for so long that
it is impossible to say whether your mother's surgeries were
avoidable. Even if they were not, it would still say nothing about
you, and while there was a medical indication to induce in your
case, nonetheless, inducing labor in a first-time mother
whose body is not ready to labor doubles her odds of
cesarean. Administering cervical ripening agents do not reduce
those odds. Considering the distress you must have been in, there
may well also have been emotional factors interfering with
your ability to birth your child.

If you are trying to decide between planning a VBAC or a repeat
cesarean, I see three components to making the decision. The
first two have to do with you. One component is to acquire
complete, unbiased information on the benefits versus harms of
planned VBAC versus elective repeat surgery. Lamaze has a guide
to VBAC on its website that can help. The second component is
dealing with the emotional aftermath of your first birth. Neither
you nor your husband will be able to make the best decision for you
and your family if the decision is driven by fear. The third
component only applies if you decide to plan a VBAC and it is
finding a care provider who attends them. Few do these days, and
shame on those who do not because while they may try to tell you
differently, it isn't about health and safety. As you will see in
the guide, both options carry risks. Moreover, once a woman has a
VBAC, she will almost always go on having uneventful VBACs with
subsequent children, but every cesarean increases the risk
of life-threatening complications in future pregnancies.
If you decide to plan a VBAC, write again if you want ideas
about how to find a VBAC-friendly care provider. If you
decide on a planned cesarean the International Cesarean Awareness
Network has a page on planning for a family-centered
cesarean experience.

~ Henci

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